2) Freegard (2006) states: “Autonomy as an ethical principle encompasses the fundamental protection and respect of persons, and freedom from interference ... A competent client should have the right to decide what is to be done with his or her body” (p. 112).

Autonomy has been practiced in nursing since Bioethics and the four principles became a prominent approach. Bioethics considers the social and moral implications of new developments in medicine and medical technology (Jecker, Jonsen, & Pearlman, 2012). Autonomy is just one of four principles, however it holds great value to both nurses and patients as it underpins respect, confidentiality and consent over personal information (Freegard, 2006). So, ethically speaking, why does it matter that patients give their consent to treatment? That their privacy is respected? And that nurses respect patient confidentiality? It is partly a matter of ‘treating others how you would like to be treated’ and partly what is required of nurses by law. By the end of this essay I intend to have shown you why all these issues ‘matter’ and how the principle of autonomy relates to, and shapes these questions. So firstly, it is vital to understand what autonomy is, and how as a nurse you demonstrate respect for patient autonomy before we divulge in to the above questions.

Autonomy ‘recognises the right of a person to have an opinion, make choices, and take actions based on personal values and beliefs’ (Freegard, 2006). It also places an obligation to others including nurses to respect this right within reason. As with all the principles, Autonomy has prima facie value which means it is not absolute when it is in conflict with another moral principle (Beauchamp, 2007) As an example, Abortion carries a large debate about the sanctity of life against the woman’s right to control her own body (autonomy) (Chater, 2010). It is important as nurses to demonstrate a respect for patient autonomy. The Code of ethics states that “nurses value respect and kindness for self and others” (Australian Nursing and Midwifery Council, 2008). This includes good communication between nurse and client. For example; listening to them, and telling them information that they both want and need, as well as respecting their wishes to decline an intervention or receive more or less information about it. All in all, providing a therapeutic relationship with the client demonstrates a respect for their personal autonomy (Gillon, 1994). Because of the prima facie value of autonomy, in some cases we are not duty bound to uphold the respect for autonomy, however in other cases such as consent, privacy and patient confidentiality we are; unless it places significant risk on the patient or people surrounding them (Chater, 2010). The Code of Ethics states that “Nurses value informed decision making” (ANMC, 2008) which shows the recognition that people have the right to be autonomous in terms of informed consent. It is a requirement to gain informed consent for any type of procedure or intervention (ANMC, 2008). Informed consent therefore promotes autonomy. Consent is, in a health care setting, defined as “the procedure whereby patients (clients) consent to, or refuse, an intervention based on information provided by a health care professional regarding the nature and potential risks (consequence and likelihood) of the proposed intervention” (Victorian Health Association, 2009).

There are three different types of consent; implied consent, verbal consent and written consent. Implied consent is shown by the clients actions, for example holding there arm out for their pulse to be taken. Verbal consent is when a client clearly states their consent verbally. I.e. - yes, you may take my blood pressure. Written Consent is when a form signed by the client declaring consent for a procedure (Australian Nursing Federation, 2009). It is important to gain consent to both respect the client’s autonomy as well as for legal protection...

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